Object: To treat hydrocephalus by ventriculo-peritoneal shunt operation, the correct positioning of the proximal catheter in the ventricle is very important. The purpose of this study was to develop the "shunt guiding kit" for the proper positioning of the proximal shunt catheter to the ventricle in the ventriculo-peritoneal shunt operation. MATERIALS AND METHODS: The "shunt guiding kit" is made of tungsten alloy and it consists of one frame, two screws and one guider. Through the guider, the proximal shunt catheter operates by mechanically coupling the posterior burr hole to the anterior target point. RESULTS: We have treated three hydrocephalus patients with use of the "shunt guiding kit", and achieved good location of proximal shunt catheters. CONCLUSION: We developed the "shunt guiding kit" for the proper positioning of the proximal shunt catheter to the ventricle, and this would be very useful for preventing ventriculo-peritoneal shunt malfunction and preventing possible brain injury during the procedures.
Alloys ; Brain Injuries ; Catheters* ; Humans ; Hydrocephalus ; Lateral Ventricles* ; Tungsten ; Ventriculoperitoneal Shunt*

Influenza-associated encephalopathy is regarded as one of the major neurologic disease entities along with those of Reye syndrome, acute necrotizing encephalopathy, and myelitis which are known to be related to influenza virus, mostly type A. And it is being actively researched in Japan as it has caused a tremendous increase in the number of deaths from 1997 to 2002, but it has not been yet reported in the Korean pediatric medical community. It attacks those previously healthy children, who have not been vaccinated. Patients start with such symptoms as fever and common respiratory problems, but within 24 to 48 hours they suffer from seizures with acute mental deterioration, become worse, and suffer multiple organ failures including marked elevated transaminase levels as well as coagulopathy. It induces deaths in a couple of days after the symptoms appear or remains a serious neurologic sequelae. Confirmative diagnosis is used to demonstrate influenza viral infection. We report here a 37 month aged boy who was admitted to our hospital during the last influenza season under the diagnosis of influenza associated encephalopathy on the basis of serologic testing by hemagglutinin inhibition(HI). This is the first report confirmed by increased antibody titer of the influenza A virus in Korea.
Child ; Diagnosis ; Fever ; Hemagglutinins ; Humans ; Influenza A virus ; Influenza, Human ; Japan ; Korea ; Male ; Multiple Organ Failure ; Myelitis ; Orthomyxoviridae ; Reye Syndrome ; Seasons ; Seizures ; Serologic Tests

No abstract available.
Carcinoma, Transitional Cell* ; Female ; Ovary

High peak inspiratory pressure during control-mode ventilation (CMV) with volume cycled ventilator is associated with increased risk of barotrauma. Pressure controlled ventilation can reduce peak inspiratory pressure and barotrauma, and provide for adequate gas exchange. We present a case of the patient of status asthmaticus in whom we used pressure controll ventilation of lower inspiratory pressure (initially 45 cmH2O) with good outcome during midazolam infusion. At the admission to the ICU, the peak inspiratory pressure was 80 cmH2O with control- mode ventilation of volume cycled ventilator and respiratory acidosis developed (pH: 7.20, PaCO2: 64.1 mmHg). After changing the volume control mode to pressure controlled mode, the peak inspiratory pressure could be reduced from 80 cmH2O to 45 cmH2O with improvement of respiratory acidosis. From our experience, we recommend the application of pressure control ventilation safely to the patients in whom peak inspiratory pressure is high enough to induce barotrauma, if expired tidal volume is monitored.
Acidosis, Respiratory ; Barotrauma ; Humans ; Midazolam ; Status Asthmaticus* ; Tidal Volume ; Ventilation ; Ventilators, Mechanical

We report on a case of torsion of an accessory spleen occurring in a 19-year-old female. She was admitted with a three-day history of left-upper quadrant pain that became slowly aggravated. On physical examination, left-side abdominal tenderness was observed, most markedly in the left upper quadrant, but no rebound tenderness was noted. Contrast-enhanced computed tomography (CT) scan showed a non-enhancing mass with a tubular vascular pedicle and normal enhancing spleen in the left upper abdomen. Doppler ultrasound showed no vascular flow within the hypoechoic mass in the left upper abdomen. Torsion of an accessory spleen was suspected, and emergent laparoscopic exploration was performed. Laparoscopic exploration showed a large rounded violet mass with a tw isted vascular pedicle, located anterior to the normal spleen. The mass was excised laparoscopically and then removed through a 2.5 cm extended incision of the left-sided trocar incision. Postoperative recovery was normal and she was discharged on the fifth postoperative day.
Abdomen ; Female ; Humans ; Physical Examination ; Spleen* ; Surgical Instruments ; Ultrasonography ; Viola ; Young Adult

We report on a case of torsion of an accessory spleen occurring in a 19-year-old female. She was admitted with a three-day history of left-upper quadrant pain that became slowly aggravated. On physical examination, left-side abdominal tenderness was observed, most markedly in the left upper quadrant, but no rebound tenderness was noted. Contrast-enhanced computed tomography (CT) scan showed a non-enhancing mass with a tubular vascular pedicle and normal enhancing spleen in the left upper abdomen. Doppler ultrasound showed no vascular flow within the hypoechoic mass in the left upper abdomen. Torsion of an accessory spleen was suspected, and emergent laparoscopic exploration was performed. Laparoscopic exploration showed a large rounded violet mass with a tw isted vascular pedicle, located anterior to the normal spleen. The mass was excised laparoscopically and then removed through a 2.5 cm extended incision of the left-sided trocar incision. Postoperative recovery was normal and she was discharged on the fifth postoperative day.
Abdomen ; Female ; Humans ; Physical Examination ; Spleen* ; Surgical Instruments ; Ultrasonography ; Viola ; Young Adult

Extracellular matrix component is degraded by enzymes of thematrix metalloproteinases(MMPs). MMPs are produced by both hemopoietic and structural cells. Increased activity of MMP-3 in periodontium is strongly associated with inflammatory periodontal disease. The purpose of the present study was to estimate the effect of BMP-7 on regeneration of periodontium. The optical density was measured by microwell plate reader at 450 nm.The difference of the optical density and the relative activity ofMMP-3 according to the concentration were statistically analyzed by one way ANOVA. The results were as follows: 1.Tetracycline-HCl showed the tendency to inhibit the activity of MMP-3 at the concentration lower than 25microgram/ml. 2.Doxycycline-HCl inhibited significantly the activity of MMP-3 at the concentration lower than 100microgram/ml. 3.Minocycline-HCl inhibited the activity of MMP-3 at the concentration in the range of 10 to 200microgram/ml. Within the limit of the present study, the above results suggested that bone morphogenetic protein-7 may play a important role in development of periodontium.
Bone Morphogenetic Protein 7 ; Extracellular Matrix ; Matrix Metalloproteinases ; Periodontal Diseases ; Periodontium ; Regeneration

OBJECTIVES: This study investigated lung function in workers exposed to dusts, fumes and noxious gases at small foundries. METHODS: Lung function was measured in 148 male workers from 12 small foundries and 202 unexposed male workers. Pulmonary function tests performed included: forced vital capacity (FVC), forced expiratory volume in one second (FEV1), percent of FEV1/FVC (FEV1/FVC%), maximum mid-expiratory flow (MMEF), peak expiratory flow (PEF), and forced expiratory flow at 25, 50, and 75% of expired FVC (FEF25, 50, 75). RESULTS: Mean values of all ventilatory indices except FEF25 of foundry workers were significantly lower than those of controls. Specifically, following stratification by smoking habits, all ventilatory indices except FEF25 of foundry workers were significantly lower than those of controls who smoked; however, there were no significant differences observed in any ventilatory indices between nonsmoking exposed workers and controls. The results of multiple linear regression analysis indicated work duration as a significant predictor of a decrease in FVC%. CONCLUSIONS: This research indicates that combined occupational exposure to dust, fumes, and gases in small foundries is associated with a reduction in lung function. Smoking may also contribute to respiratory abnormalities. These results suggested that foundry workers should be required to undergo periodic lung function tests and-in addition to not smoking, efficient use of personal protection equipment while at work is recommended.
Dust ; Forced Expiratory Volume ; Gases ; Humans ; Linear Models ; Lung ; Male ; Occupational Exposure ; Respiratory Function Tests ; Smoke ; Smoking ; Vital Capacity

Varicella-zoster virus (VZV) is a causative agent for chickenpox in primary infection and shingles after reactivation from latency. Both varicella and zoster can be prevented by live attenuated vaccines, but the molecular mechanism of attenuation is not clearly understood. In this study, the genome sequences of three varicella vaccine strains were analyzed for the genetic diversity including single nucleotide polymorphism (SNP) and genetic polymorphism. A total of 38 SNPs were identified including 29 substitutions and 9 insertion/deletions. The number of genetically polymorphic sites (GPS) was highest in Varivax and lowest in Varilrix. GPS in the R region including R1, R2, and R3 appeared to be responsible for the genetic polymorphisms in the open reading frame (ORF) 11, 14, and 22 in all three vaccine strains. A relatively large number of GPS were observed in ORF31, 55, and 62, which are known to be essential for virus replication, suggesting that the attenuation of the vaccine strains may be attributed by the diversity of these genes.

A cerebral infarction involving the nodulus usually produce contralateral lateropulsion and ipsilateral spontaneous nystagmus to the lesion. Here, we report a case of atypical isolated nodular infarction showed ipsilateral lateropulsion and contralateral spontaneous nystagmus to the lesion with a normal head impulse test. A right-handed 70-year-old man developed sudden vertigo with an unsteady gait. Neurologic examination revealed spontaneous left-beating nystagmus with a torsional component. He also displayed imbalance of walking and axial lateropulsion to the right side. Head impulse test was normal. Magnetic resonance imaging indicated acute infarction in the right nodulus on diffusion-weighted images.
Cerebral Infarction ; Gait Disorders, Neurologic ; Head ; Infarction ; Magnetic Resonance Imaging ; Neurologic Examination ; Vertigo ; Vestibular Neuronitis ; Walking